Background: Static hamstring stretching exercises have been widely used to improve flexibility of the hamstring muscles. However, few studies have examined the influence of standing static hamstring stretching (e.g., jack-knife stretching) on movements of the lumbopelvic–hip complex. Objectives: To examine the short-term effects of jack-knife stretching on movements of the lumbopelvic–hip complex. Design: Case series. Methods: Fourteen participants with hamstring tightness (8 male, 6 female) were recruited. Participants performed jack-knife stretching for 150 s. Before and after stretching, participants performed the finger-to-floor distance (FFD), sit and reach (SRT), active knee extension (AKE), passive straight leg raising (PSLA), and active straight leg raising (ASLR) tests as well as pelvic tilt while standing to identify the effects of stretching. Results: There were significant improvements in the FFD, SRT, AKE, PSLA, and ASLR tests after stretching. However, pelvic tilt angle while standing did not significantly change. Conclusion: Jack-knife stretching can be a useful exercise to improve flexibility of the hamstring muscles, but not pelvic alignment while standing.

Background: With the increasing elderly population, the need for gait analysis of these elderly individuals is also increasing. Most devices are costly and not portable; however, smartphones using built-in sensors capable of measuring motion and are easily available. Objectives: To examine the reliability and validity of knee joint angles of the elderly using smartphone measurements during walking. Design: Quasi-experimental research. Methods: Sixteen elderly people, aged 65+ and living in Daejeon and Chungbuk, South Korea, participated in the study. Electrogoniometers and smartphones were attached to the thigh and the side and front of the shank of each subject, respectively, using double-sided tape, an arm band, and an elastic band. Each subject completed two sets of at least seven gait cycles (14 steps). Results: Both the smartphones and electrogoniometers exhibited high agreement in terms of their primary and secondary measurements (ICC>.75). The agreement between the smartphones and electrogoniometers was also high in terms of both the primary and secondary measurements (ICC<.60). Conclusion: These results indicate that smartphones can be costly equipment cannot, even though they cannot completely replace existing clinical-grade devices. Their utility is emphasized herein for measuring knee joint angles of the elderly during walking.

Background: Patients with stroke have core muscle weakness and limited rib cage movement, resulting in restrictive lung disease. Objectives: To examine the comparison of effects of rib cage joint mobilization combined with diaphragmatic breathing exercise and diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Design: A cluster randomized controlled trial. Methods: Twenty-four patients were randomly assigned to an experimental group (rib cage joint mobilization combined with diaphragmatic breathing exercise group) and control group (diaphragmatic breathing exercise group). Patients in the experimental group underwent rib cage joint mobilization for 15 min and diaphragmatic breathing exercise for 15 min. The control group underwent diaphragmatic breathing exercise for 30 min. Both groups underwent exercise thrice a week for 4 weeks. The pulmonary function and chest circumference were measured using the MicroLab spirometer and a tape measure, respectively. Results: After the intervention, the pulmonary function and chest circumference significantly improved in both groups. These improvements were significantly higher in the experimental group than those in the control group. Conclusion: Rib cage joint mobilization combined with diaphragmatic breathing exercise improves pulmonary function and chest circumference in patients with stroke.

Background: Adults with forward head posture (FHP) often suffer from thoracic hyperkyphosis and thoracic dysfunction, and including reduction of the craniovertebral angle (CV angle) and tightening of the superficial neck muscles. In order to treat thoracic dysfunction, interventions aimed at improving thoracic mobility are necessary. Objectives: To examine the effects of maitland manual mobilization therapy on the thoracic spine in adults with FHP. Design: Single-blind randomized controlled trial. Methods: Thirty adults with FHP who met the selection criteria were randomized to the thoracic multiple joint mobilization (TMJM; n=15) group and the thoracic general joint mobilization (TGJM; n=15) group. Joint mobilizations were performed for 23 minutes a day for 4 weeks continuously, two times per week. Outcome measures were ImageJ, BTS FREE EMG 1000, neck disability Index (NDI). Results: Although changes in the left sternocleidomastoid muscle activity and NDI scores over time between the two groups differed, other variables were noted only changes observed over time. Muscle activity in the right sternocleidomastoid increased again in the TGJM group post-intervention and 2 weeks after the end of the experiment, but changes in other variables were retained or improved, confirming the lasting effects of thoracic joint mobilization. Conclusion: Thoracic multiple joint mobilization may be recommended as a more effective intervention for adults with FHP.

Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.

Background: Recently, a new method of dysphagia rehabilitation using Kinesio taping (KT) has been attempted and demonstrated an immediate increase in the activation of the suprahyoid muscle during swallowing in healthy adults. Objectives: To investigate the effect of dysphagia rehabilitation using KT on the thickness change of the suprahyoid muscle in patients with dysphagia after stroke. Design: Two-group pre-post design. Methods: In this study, 20 patients with dysphagia after stroke were enrolled and assigned to the experimental and control groups. The experimental group applied KT to the front of the neck and repeatedly swallowed against the tension of the tape. On the other hand, the control group performed repeated swallowing without applying KT. Patients in both groups had swallowed 50 times a day/5 times a week for 4 weeks. For evaluation, the volume of the geniohyoid, mylohyoid, and digastric muscle was measured before and after the intervention using portable ultrasound equipment. Results: As a result of comparing the two groups after the intervention, the experimental group showed more volume increase in mylohyoid (P<.05) and digastric muscle (P<.05) than the control group. Conclusion: This study proved that suprahyoid muscle resistance exercise using KT is effective in increasing the volume of the suprahyoid muscle.

Background: Stroke patients exhibit arm global synkinesis (GS), involuntary movement due to muscle weakness and irregular muscle tension. But currently there are few studies examined the effects of GS on activates of daily living in stroke patients. Objectives: To investigate the effects the effects of task-oriented bilateral movements, which promote brain plasticity and are based on neurological theory, using the unaffected arm and the affected arm. Design: Quasi-randomized trial. Methods: Twenty stroke patients were randomly assigned to experimental group I (n=10) and experimental group II (n=10). Before the intervention, arm GS was measured using surface electromyography, and the Motor Activity Log evaluated the quantitative and qualitative uses of the affected arm in daily life. The same items were measured four weeks later. Results: The changes in the GS of the arm of experimental group I showed statistically significant differences only in bending motions (P<.05). Both groups showed statistically significant differences in the amount of use (AOU) and the quality of movement (QOM) scores (P<.01). Comparing the groups, statistically significant differences in GS appeared during bending motions (P<.05), and in the AOU (P<.01) and the QOM scores (P<.05). Conclusion: The intervention in GS reduced the abnormal muscle tension of the affected side by increasing the use of the ipsilateral motor pathway, indicating its effectiveness in improving upper limb functions with smooth contraction and relaxation of the muscles.

Background: Improperly conducted exercise may lead to worsening of musculoskeletal complications. Such may worsen due to increased repetition and intensity during exercise. In addition, different responses may show different needs for training program. Objectives: To compare kinematics of symmetric concentric and eccentric motions during increased repetitions and intensities for men and women. Design: Quasi-randomized trial. Methods: A total of ten men and eleven women participated in this study. Concentric and eccentric motions of the lateral raises were observed for initial positions of abduction and adduction. Low and high exercise intensities were applied, and 15 repetitions were conducted for both intensities. Initial, 3 inbetween repetitions, and last repetition were recorded for comparisons. Results: The concentric or abduction motions showed no significant differences for all comparisons. However, eccentric or adduction motions showed greater significant differences as the exercise intensity increased for both men and women. Such significant differences were most prevalent during the first and last repetitions with greatest differences during the initial repetitions. Conclusion: Kinematic difference between men and women during increased repetitions and intensity indicate the need for more individualized exercise intervention and consideration between men and women. Individualized interventions may prevent exercise-induced postural abnormality and corresponding musculoskeletal dysfunction.

Background: Various treatments have been proposed for chronic low back pain (CLBP), but recent guidelines and reviews recommend regular physical exercise. However, some other studies have reported opposite results that sling exercise (SE) and other exercises (OE) did not differ in improving CLBP. Objectives: To systematically review and meta-analyze the effects of SE on CLBP in studies published in Korea. Design: A Systemic Review and Meta-analysis. Methods: Randomized controlled trials comparing SE with OE and modality therapy (MT), published up to June 2020, were identified by electronic searches. Primary outcomes were pain and disability. The weighted mean difference (WMD), stand mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model. Results: Based on the results of the meta-analysis, SE was effective for pain in the comparison of SE and MT [short-term: WMD=-1.64, 95% CI (-3.06, - 0.22); long-term: WMD=-0.34, 95% CI (-0.42, -0.26)]. It was effective for pain in the comparison of SE and OE [short-term: WMD=-1.18, 95% CI (-2.15, - 0.20); long-term: WMD=-0.66, 95% CI (-0.89, -0.43)]. It was also effective for disability in the comparison of SE and MT [short-term: SMD=-15.82, 95% CI (- 23.10, -8.54)]. We found no clinically relevant differences in disability between SE and OE. Heterogeneity was high in the comparison of SE and overall variables. Conclusion: If SE is applied to physical therapy to improve the main symptoms of CLBP patients, it may contribute to their recovery. More high-quality randomized studies on the topic are warranted.

Background: Stroke patients have multiple disorders, but most have problems with balance and gait. Post-stroke rehabilitation exercise has been shown to be very important for functional recovery. Objectives: To systematically review and meta-analyze the effects of sling exercise (SE) on patients with stroke in studies published in Korea. Design: Meta-analysis. Methods: Five databases, namely, RISS, KISS, NDSL, DBpia and Earticle, were used to collect articles on vibration. Keywords such as “Stroke,” “Hemiplegia,” “Sling,” and “Sling Exercise” were used in the search for published articles. Interventions and comparisons were SE and other exercise (OE). Outcome measures were berg balance scale (BBS) and timed up and go (TUG). Consequently, eight studies were selected in the second screening using meta-analyses. Results: Based on the results of the meta-analysis, SE was effective for BBS in the comparison of SE and OE [2.71, 95% CI (1.42, 4.01)]. It was effective for TUG in the comparison of SE and OE [-1.89, 95% CI (-3.01, -0.77)]. Conclusion: Based on eight limited studies, SE improved BBS and TUG over OE, suggesting improved stroke balance and gait. Therefore, more studies and large-scale sample randomized controlled trials are needed to confirm clinical application.